2023-06-14 17:17:14
The number of deaths of young children stopped falling in 2005. Several hypotheses have been put forward to try to explain the situation.
In France, the infant mortality rate has not fallen since 2005. It may even have increased. The country does poorly next to its European neighbors for whom the trend is opposite, notes INSEE, in a report published on Wednesday June 14.
“In 2021, 2,700 children born alive died in France before their first birthday”, underlines the report from the outset. The infant mortality rate has thus fallen from 3.32 deaths per 1,000 births in 2012 to 3.7 deaths per 1,000 births in 2021. How can this deterioration be explained? “Already it concerns more particularly neonatal mortality, that is to say deaths that occur in the first 7 days of life,” says Chloé Tavan, head of the surveys and demographic studies division of INSEE.
Between 2005 and 2021, neonatal mortality fell from 1.6% to 1.9% in 2021, while the post-neonatal mortality rate, following the 28e day of life, has been falling since 2005. Paradoxically, progress in neonatal medicine is one of the hypotheses raised by the report. The sophistication of medical techniques now makes it possible to give birth to very premature babies who, in the past, would not have been born alive. “But despite everything, these premature babies remain very fragile and still present a higher risk of mortality than other babies in the first days of their life, which might also have contributed to the deterioration of the average infant mortality rate in France”explains Chloé Tavan. “However, it is difficult to identify a single cause for the phenomenon, which probably has a multifactorial origin”she continues.
Misunderstood phenomenon
The main lesson of this study remains that since 2015 the infant mortality rate in France has been higher than the European Union average. “France was in third position between 1996 and 2000, but is now in twentieth position with a drop of only 20% in two decades”, summarizes the report. Not very flattering. If we compare France to its neighbours, a remarkable decrease in the mortality rate has been noted for countries where it was precisely formerly very high, such as Romania, Cyprus, Hungary, Bulgaria or even Poland. But it also fell in countries where this rate was low, such as Sweden, where it fell from 3.6% to 2.3% on average between 1996 and 2000, ie a drop of 36%. In Germany, on the other hand, the decline in the infant mortality rate has slowed down in recent years, like in France.
The most difficult thing is that today we only have hypotheses to explain the phenomenon, which remains misunderstood. “There are three main families of determinants”, states Chloé Tavan. The first would relate to the individual characteristics of the child such as birth weight and degree of prematurity. “The second point that we can mention concerns the difference that exists between the different countries in terms of the supply of care, medical techniques or even the development of drugs”. Finally, certain socio-economic factors might have their share of responsibility. The fact of having a child at a more or less late age but also smoking and alcohol consumption during pregnancy are examples. According to the Public Health France barometer, in 2017 20% to 25% of women continue to smoke during their pregnancy. However, several studies have already shown the link between smoking and maternal and child health. “But there are certainly many other causes, which should certainly encourage further studies to be carried out”concludes Chloé Tavan.
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